PrEP Disparities Among Transgender Feminine, Transgender Masculine, Nonbinary, and Gender Expansive Youth and Young Adults in the United States

IF 2.4 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH AIDS and Behavior Pub Date : 2025-01-31 DOI:10.1007/s10461-024-04590-x
Anne E. Fehrenbacher, Demetria Cain, Joshua A. Rusow, Swetha Lakshmanan, Dianna Polanco, Demi Ward, Yara Tapia, Risa P. Flynn, Patrick S. Sullivan, W. Scott Comulada, Keith J. Horvath, Cathy J. Reback, Dallas T. Swendeman, Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) CARES Team
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Abstract

This study assessed disparities in pre-exposure prophylaxis (PrEP) use among transgender and gender expansive youth and young adults (N = 477) between 15 and 24 years old in the CARES (ATN 149) and TechStep (ATN 160) study protocols within the National Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN). Structural equation modeling was used to test mediation pathways between gender identity and PrEP uptake among the full sample and stratified by sex assigned at birth. Lifetime PrEP uptake was higher among those assigned male at birth (26%) versus assigned female at birth (9%), explained by greater structural and behavioral risks and perceived need for PrEP, especially among trans women. Among those assigned female at birth, PrEP uptake was higher among trans men (12%) than nonbinary participants (6%). Our findings characterize key structural and behavioral drivers of PrEP use and highlight the need to reduce barriers to healthcare for trans youth, particularly in the South.

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美国跨性别女性、跨性别男性、非二元性和性别膨胀青年和年轻人的PrEP差异
本研究评估了在国家艾滋病毒/艾滋病干预青少年医学试验网络(ATN)的CARES (ATN 149)和TechStep (ATN 160)研究方案中,15至24岁的跨性别和性别扩张青年和年轻人(N = 477)在暴露前预防(PrEP)使用方面的差异。采用结构方程模型在全样本中测试性别认同与PrEP摄取之间的中介途径,并按出生性别分层。出生时被指定为男性的终生PrEP使用率(26%)高于出生时被指定为女性的(9%),这是由于更大的结构和行为风险以及对PrEP的感知需求,特别是在跨性别女性中。在出生时被指定为女性的参与者中,跨性别男性的PrEP使用率(12%)高于非二元性别参与者(6%)。我们的研究结果描述了PrEP使用的主要结构和行为驱动因素,并强调了减少跨性别青年获得医疗保健障碍的必要性,特别是在南方。
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来源期刊
AIDS and Behavior
AIDS and Behavior Multiple-
CiteScore
6.60
自引率
13.60%
发文量
382
期刊介绍: AIDS and Behavior provides an international venue for the scientific exchange of research and scholarly work on the contributing factors, prevention, consequences, social impact, and response to HIV/AIDS. This bimonthly journal publishes original peer-reviewed papers that address all areas of AIDS behavioral research including: individual, contextual, social, economic and geographic factors that facilitate HIV transmission; interventions aimed to reduce HIV transmission risks at all levels and in all contexts; mental health aspects of HIV/AIDS; medical and behavioral consequences of HIV infection - including health-related quality of life, coping, treatment and treatment adherence; and the impact of HIV infection on adults children, families, communities and societies. The journal publishes original research articles, brief research reports, and critical literature reviews. provides an international venue for the scientific exchange of research and scholarly work on the contributing factors, prevention, consequences, social impact, and response to HIV/AIDS. This bimonthly journal publishes original peer-reviewed papers that address all areas of AIDS behavioral research including: individual, contextual, social, economic and geographic factors that facilitate HIV transmission; interventions aimed to reduce HIV transmission risks at all levels and in all contexts; mental health aspects of HIV/AIDS; medical and behavioral consequences of HIV infection - including health-related quality of life, coping, treatment and treatment adherence; and the impact of HIV infection on adults children, families, communities and societies. The journal publishes original research articles, brief research reports, and critical literature reviews.5 Year Impact Factor: 2.965 (2008) Section ''SOCIAL SCIENCES, BIOMEDICAL'': Rank 5 of 29 Section ''PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH'': Rank 9 of 76
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